POS1196 SARS-CoV-2 VACCINE ACCEPTANCE AND ASSOCIATED PSYCHOLOGICAL FACTORS IN PATIENTS WITH RHEUMATIC AND MUSCULOSKELETAL DISEASES
Authors: H. Sugawara, H. Doi, T. Iwasaki, Y. Nakayama, Y. Nishida, Y. Gon, M. Kamakura, K. Ohbori, N. Sakane, N. Nakamura, T. Utsumi, A. Morinobu
Journal: Annals of the Rheumatic Diseases (2022)

Background The mortality rate of coronavirus disease 2019 (COVID-19) in patients with rheumatic and musculoskeletal disease (RMD) is as high as approximately 10% [1]. Therefore, vaccination promotion is a critical issue. However, there are few reports on the psychological aspects of patient vaccine acceptance. Objectives To investigate the intention of patients with RMD to receive the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine and explore the psychological factors related to vaccine acceptance. Methods We conducted a questionnaire-based survey of 406 outpatients with RMD at Shiga General Hospital from July to October 2021. The questionnaire included the following sections: (1) vaccination status; (2) expectation of susceptibility to severe COVID-19; (3) expectation of vaccine efficacy; and (4) anxiety about the vaccine, which included concerns on I) the diminishing effect of the vaccine due to current treatment and II) the influence of vaccination on: i) primary disease status, ii) treatment, and iii) adverse reaction. Results There were 305 vaccinated and 101 unvaccinated individuals. Unvaccinated individuals were classified into the acceptance group (n=60) and hesitancy group (n=41) according to their vaccination status (Figure 1). Figure 1. SARS-CoV-2 vaccination status (n=406) We compared the backgrounds and awareness of the patients on vaccination between the two groups. Univariate analysis did not show any difference in the backgrounds. The expectation of susceptibility to severe COVID-19 was similar in both groups. There were also no significant differences in the vaccine-related anxiety levels. However, the expectation of vaccine efficacy was higher in the acceptance group and significantly influenced vaccination intention as revealed by multivariate analyses (Table 1). Table 1. Awareness towards COVID-19 and SARS-CoV-2 vaccine associated with vaccination intention Awareness towards COVID-19 and SARS-CoV-2 vaccine Acceptance(N=60) Hesitancy(N=41) UnivariateAnalysis § Multivariate Analysis || Median [IQR] Median [IQR] p -value p -value Expectation of susceptibility to severe COVID-19 * 2.0 [1.0-3.0] 2.0 [1.5-2.5] 0.8472 0.3440 Expectation of vaccine efficacy † 3.0 [3.0-3.0] 2.0 [1.0-3.0] &lt;0.0001 ¶ &lt;0.0001 ** Concerns about the diminishing effect of the vaccine due to current treatment ‡ 2.0 [1.0-3.0] 3.0 [2.0-3.0] 0.0475 0.3600 Concerns about the effect of vaccination on treatment ‡ 3.0 [1.0-3.0] 3.0 [2.0-4.0] 0.0128 0.6232 Concern about the effect of vaccination on primary disease status ‡ 3.0 [1.0-3.0] 3.0 [2.0-3.0] 0.0576 0.7134 Concern about the effect of vaccination on adverse reaction ‡ 3.0 [3.0-3.0] 3.0 [3.0-4.0] 0.0093 0.8335 *0: Less likely to become severe~3: Very likely to become severe, †0: Not expected at all~4: Highly expected, ‡0: Not concerned at all ~4:Very concerned §Pearson’s chi-square test or Wilcoxon test, ||Nominal logistic regression analysis, ¶ p &lt;0.008 (after Bonferroni correction), ** p &lt;0.05. Conclusion The perception of vaccine efficacy is strongly correlated with vaccine acceptance. In order to promote vaccination in patients with RMDs, this study suggests that emphasizing the efficacy of the vaccine may be more effective than alleviating anxiety about the adverse effects of the vaccine. References [1]Strangfeld, A. et al. Ann. Rheum. Dis. 2021; 80: 930–942. Disclosure of Interests Haruka Sugawara: None declared, Hiroshi Doi: None declared, Takeshi Iwasaki: None declared, Yoichi Nakayama: None declared, Yuri Nishida: None declared, Yoshie Gon: None declared, Masaki Kamakura: None declared, Kenshi Ohbori: None declared, Naoko Sakane: None declared, Naomi Nakamura: None declared, Takahiko Utsumi: None declared, Akio Morinobu Speakers bureau: Eli Lilly Japan K.K., Ono Pharmaceutical Co., Pfizer Inc., UCB Japan, AbbVie G.K., Asahi Kasei Pharma., and Chugai Pharmaceutical Co. Ltd., Grant/research support from: Eli Lilly Japan K.K., Ono Pharmaceutical Co., Pfizer Inc., UCB Japan, AbbVie G.K., Asahi Kasei Pharma., and Chugai Pharmaceutical Co. Ltd.